Reimbursement

On the 28th of July 2020, in the Official Journal of French Republic (JORF), an Order for the inclusion of the web application MOOVCARE POUMON intended for the medical telemonitoring of relapses and complications in patients with non-progressive lung cancer in the French List of Products and Healthcare Services Qualifying for Reimbursement (LPPR) was published. The application is already included in the LPPR list in section 1, “Materials and treatments in the home, dietary products, items for dressings,” chapter 1, section 7, and a specific sub-section 7, which has been created for web applications and software for remote monitoring.

In July 2020, new material code and related conditions of reimbursement concerning the endoscopic treatment of primary or secondary vesicoureteral reflux were added to the List of reimbursable devices of the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV).

The Clinical Coding and Schedule Development (CCSD) group develops and maintains procedural and diagnostics nomenclature for private payers in England. New procedure codes concern planning, insertion, and removal of high/low dose rate radioactive treatment (brachytherapy) into a prostate tumor, open/laparoscopic repair of Spigelian hernia, and others. The codes are introduced with a recommended adoption date being the 1st of August 2020. The document also contains a list of textual changes in codes and unacceptable combinations. There were no changes to the CCSD Schedule of Diagnostic Tests.

In June 2020, santésuisse (the leading organization of Swiss health insurers) and the Swiss Society of Surgeons (FCMH) have submitted a proposal to the Federal Council for the acceptance of 67 lump-sum payment packages for out-patient services. In July 2020, eight more lump-sum payment packages were suggested to the Federal Council. More suggestions are expected in the near future.

The revised EBM (German Uniform Evaluation Standard) catalog came into force on July 1, 2020. MTRC has compiled the selection of the most significant changes.

In March 2020, the Dutch Healthcare Institute advised the Ministry of Health, Welfare, and Sport to simplify the reimbursement to diabetes care aids. In accordance with this advice, the Real-Time Continuous Glucose Monitoring (RT-CGM) and ketone test strips will no longer fall under specialist medical care (MSZ) but will be covered by medical aid care (HMZ). The new scheme is intended to take effect on 1 January 2021.

In March 2020, the Dutch Healthcare Institute advised the Ministry of Health, Welfare, and Sport to simplify the reimbursement to diabetes care aids. In accordance with this advice, the Real-Time Continuous Glucose Monitoring (RT-CGM) and ketone test strips will no longer fall under specialist medical care (MSZ) but will be covered by medical aid care (HMZ). The new scheme is intended to take effect on 1 January 2021.

The Corona warning app, developed on behalf of the German government, has been available for download in the Google and Apple stores since June 16, 2020. It is intended to help identify and break infection chains at an early stage. Users of the app receive a notification if they have been for a long time in the vicinity of a person who was later found to be infected with the coronavirus.

New material codes and related conditions of reimbursement for an isolated iliac bifurcation endoprosthesis were added to the List of reimbursable devices of the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) in June 2020.

The French High Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in June 2020 concern various types of devices, including total lumbar disc prostheses, arthroscopic meniscal repair system, vagus nerve stimulation system, and medical aids. A total of 10 decisions were made.

On 9 May 2020, the Reimbursement Commission made changes to the SUT regarding response to the COVID-19 pandemic and introduced codes for IVD tests for Covid-19 (SARS-CoV-2) reverse transcriptase PCR and detection of Covid-19 antigen, IgG, IgM.